INTRAOPERATIVE LEVELS OF COAGULATION FACTORS IN PATIENTS TREATED WITH OPEN AND ENDOVASCULAR REVASCULARIZATION OF OCCLUDED TIBIAL ARTERIES.

Aims - to determine levels of specific coagulation factors pre-operatively and intraoperatively in patients treated with either open or endovascular surgery for occlusion of infrainguinal arteries. Study design: Randomized controlled trial. Methodology: The study included 96 patients with atherosclerotic stenotic-occlusion lesions of the infrainguinal arteries. They were divided into two groups, A and B. The patients were either treated with open surgeryor endovascular surgery. Markers assessed included fibrinogen, fibrin stabilizing factor, thromboplastic blood activity, soluble fibrin monomer complexes, Plasma recalcification time, Platelet aggregation, and D-dimers amongst others. These were checked pre-operatively and post-operatively. All markers noted were higher in the experimental group compared to the control group. When comparing pre-operatively and intraoperatively, the values were even higher in the latter. Values between open and endovascular repair were more or less comparable. Extended duration of intraoperative time can lead to significant elevation of coagulation markers regardless of choice of surgery. This is not influenced by the preoperative state of the patient. While it is expected for the levels to fall in the patients eventually in the coming days, until then they are at higher risk for complications such as DIC. These markers can be used to guide decisions on whether to prolong revascularization surgery in infrainguinal arteries.